Ch 25 resp

Question 1

difference w adult

Answer 1

1. shorter neck
2. trach increase in length until 5yr
3. bronchi split higher- especially rt
4. flexible cartilage-need proper pos

Question 2

lower resp

Answer 2

1. alveoli dev at 32wks- no gas exchange before 24wk
2. bronchioli narrow w less alveoli (8yr)
3. diaphragm used for breathing until 5yr
4. higher O2 consumption

Question 3

foreign body aspiration

Answer 3

1. chew and swallow not until 4yr
2. right lung
3. choke, dyspnea, tachypnea
4. sit forward w neck extended
5. asymptomatic after cough 15-30 min
6. chronic cough, recurrent pneumonia, lung abcess-no response to meds

Question 4

RR newborn, 1yr, 3yr

Answer 4

1. 30-60
2. 20-40
3. 20-30

Question 5

RR 6yr, 10yr, 17yr

Answer 5

1. 16-22
2. 16-20
3. 12-20

Question 6

hypoxia S/S

Answer 6

increse restlessness, irritability, unexplained sudden confusion, rapid heart/RR

Question 7

ARDS

Answer 7

• hypoventilation of lungs
• does not respond to O2
• sepsis, pneumonia, meconium aspiration, stomach contents aspiration, smoke, drown

Question 8

apnea

Answer 8

• no breath 20+sec

- decreasing RR critical sign

Question 9

central apnea

Answer 9

complete cessation of breath

Question 10

obstructive apnea

Answer 10

absence of nasal airflow when respiratory efforts present

-sleep 3-6yrs-> tonsils and adenoids hypertrophy

Question 11

mixed apnea

Answer 11

central resp pause that either preceedes or follows airway obstruction

Question 12

apnea treat

Answer 12

caffiene, positioning, tactile stim

-toxic- tachyC, tachyP, jitteriness, tremors, seizure, vomit

Question 13

apparent life threat event

Answer 13

apnea w skin color change, limp muscle tone, choke/gag

Question 14

SIDS

Answer 14

• sudden death under 1yr during sleep
• 2-4mo
• frothy blood tinged sputum
• pacifyier helps

Question 15

SIDS risk

Answer 15

1. preterm/LBW
2. native american, black
3. males
4. maternal smoke, drink, drugs
5. SES

Question 16

initial resp fail s/s

Answer 16

1. restlessness
   2 TachyP
2. TachyC
3. diaphoresis

Question 17

early decompensation S/S

Answer 17

1. nasal flare
2. retractions
3. grunting
4. wheezing
5. anxiety/irritable
6. mood changes
7. headache
8. HTN
9. confusion

Question 18

severe hypoxia and imminent resp distress s/s

Answer 18

1. dyspnea
2. bradyC
3. cyanosis
4. stupor and coma

Question 19

croup

Answer 19

• no visual inspection or throat culture
• abrupt nighttime onset
• afebrile
• resolves 24-48hrs, maintain airway, oral hydration

Question 20

epiglottitis s/s

Answer 20

1. dysphonia-talking hurts
2. dysphagia-swallow
3. drooling
4. distressed resp w stridor
   - can’t lay flat-tripod

Question 21

epiglotitis tx

Answer 21

1. no inspection/culture
2. intubate
3. acute drooling ominus
4. don’t cry

Question 22

bacterial tracheitis

Answer 22

• secondary infection after laryngotracheobronchitis
• lies flat
• worse after nebulizer